title: Barriers to the implementation of medication-assisted treatment for substance use disorders: the importance of funding policies and medical infrastructure.
abstract: Despite growing interest in the use of evidence-based treatment practices, adoption of pharmacotherapies for treating substance use disorders (SUDs) remains modest. Using data from telephone interviews with 250 administrators of publicly funded SUD treatment programs, this study estimated a model of adoption of medication assisted treatment (MAT) for SUDs and examined the relative importance of regulatory, cultural, medical resource, patient-level, and funding barriers to MAT implementation. MAT-adopting programs had significantly greater medical resources, as measured by the employment of physicians and nurses, than non-adopting programs. Administrators of non-adopting programs were asked to rate the importance of 18 barriers to MAT implementation. The most strongly endorsed barriers were regulatory prohibitions due to the program's lack of medical staff, funding barriers to implementing MAT, and lack of access to medical personnel with expertise in delivering MAT. Barriers related to insufficient information about MAT and unsupportive staff attitudes were not widely endorsed. These findings suggest that efforts to promote the implementation of MAT that are inattentive to funding barriers and weaknesses in medical infrastructure may achieve sub-optimal results.
authors.affiliation: Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 109 Medical Behavioral Science Bldg., Lexington, KY 40536-0086, USA. hannah.knudsen@uky.edu
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Knudsen
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Abraham
authors.forename: Carrie B
authors.initials: CB
authors.lastname: Oser
mesh_terms: D016001:Confidence Intervals; D006291:Health Policy / Q000191:economics*; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D015277:Hotlines; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D012306:Risk; D016320:Substance Abuse Treatment Centers / Q000191:economics* / Q000458:organization & administration; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000191:economics; D014481:United States; D014482:United States Substance Abuse and Mental Health Services Administration